Holmium Laser Intrarenal Lithotripsy in Pyelocaliceal Lithiasis Treatment: to Dust or to Extractable Fragments
R. Mulţescu, B. Geavlete, D. Georgescu, P. Geavlete, L. ChiuţuOriginal article, no. 1, 2014
Background: Pyelocaliceal calculi flexible ureteroscopicapproach raises problems related to operative time, associatedmorbidity and costs, especially by potential endoscope damage.Methods: 5 series, each of 20 patients with single pyelocaliceallithiasis, were analyzed: Group I with calculi 1 cmfragmented to dust, Group II with calculi 1 cm withlithotripsy in fragments, Group III with calculi of 1-2 cmfragmented to dust, Group IV with calculi of 1-2 cm withlithotripsy in fragments, Group V with calculi of 1-2 cmfragmented to dust until they reached 1 cm, and lithotripsy infragments afterwards. In all cases Ho:YAG lithotripsy was used.Results: Ureteral access sheath was used in 70% of the cases.Mean operating time was 39 min in group I, 21 min inGroup II, 112 min in group III, 72 min in group IV and 51min in group V. Minor complications occurred in 7 cases,while a single major complication occurred in group IV.Conclusions: The optimal lithotripsy method for calculi 1cm seems to be in extractable fragments. Larger calculishould be fragmented to dust until they reach 1 cm and thenthe lithotripsy should be continued into extractablefragments.Abbreviations: Ho: YAG â€" Holmium: Yttrium AluminiumGarnet, Hz â€" Hertz, mJ â€" milli joule
